Well, actually it was 15 weeks and 5 days, or maybe even 15 weeks and 3 days if you go by my first ultrasound. But who's counting?
I met the only female doctor in the practice today (there are also 2 male doctors and 1 female nurse practioner). I had heard that the female doctor (Dr. Z) was very nice, but not quite as personable as the males.
I actually liked her quite a bit, but maybe I caught her on an especially good day. She asked me if I had talked to to any of the other doctors about whether or not I wanted to VBAC. In fact, everyone I've seen so far as asked me about my labor plans. I'm taking this as a good sign.
Since she brought it up, I decided to ask the question I had intended to save until my next appointment with Dr. H. (who owns the practice). I asked about numbers. Specifically, how many successful VABCS the office has delivered.
She thought for a moment, and then said "Hmmm, I'm not sure if I can answer that".
She went on to explain that the practice's VBAC success rate is actually higher than the nationwide average, but that she attributed that to their selection process. In other words, they have a high VBAC success rate because they try to weed out patients that "probably won't be successful".
This had me worried. I asked her what situations would indicate that a patient wasn't a favorable candidate. She explained that the best case scenario would be one in which the patient goes into labor on her own. She said inductions often led to c-sections. I knew this to be true, so that was good.
I asked how long I could go before they would insist on an induction, and she said 42 weeks. I am actually OK with that--it seems longer than what most OB's allow. It's certainly longer than my last OB would have been comfortable with.
Dr. Z. said another scenario that could potentially limit the success of a VBAC would be "if [I] were carrying a 9 lb baby". This had me concerned too, because I know that ultrasounds and other measurement tools are only estimates, and women are fully capable of birthing big babies anyway.
However, she didn't say it would prevent me from trying--only that it might limit my chances of being successful. And she stressed at least twice that the end result would be my decision. So then I asked why this office was willing to do VBAC's when so many others in the area won't.
She answered honestly.
"It's because we've been fortunate enough not to have been slapped with a malpractice suit". And she knocked on the wooden door as she said it.
I don't know. I felt comfortable with her answers when I left. Either the practice is full of bold faced liars or they really do support a woman's right to make decisions about her own delivery.
We shall see.
On another note, I get to schedule my fetal anatomy ultrasound any day after November 11th. DH wants to find out the sex and I think I want to be surprised. It's probably not worth battling it out thought--when I get there I doubt I'll have the willpower not to find out!
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5 comments:
You need to get those numbers! I suggested that a friend ask her doctor what his episiotomy rate was (because she really wanted to avoid one) and he said that he cut them only when absolutely necessary. She pushed him for numbers (it took awhile, he had to check his charts, but OF COURSE doctors keep these stats) and it turned out that his rate was around 90%. Find out what the hospital's cesarean rate is as well.
I am going to ask Dr. H.--I agree--I need to know the exact numbers.
The hospital c-section rate is pretty typical for this area (It's Fair Oaks Inova). Their VBAC rate is higher than most local hospitals (though not as high as Arlington where Tchabo delivers, of course).
Why do you think Loudoun's VBAC rate is so low? Is it b/c the midwife group won't do VBAC's for new patients?
I aslso thought it was interesting that the Army Hospital has a high VBAC rate and a low primary c-section rate. Any thoughts on that?
And Prince William Hospital has NO VBAC's--did they ban them??
Unfortunately all of the NoVa and DC hospitals have pretty poor VBAC statistics and I think this is because if you really want to have a hospital VBAC, you need to show up 10 centimeters and pushing or pretty darn close to that. This is what the midwives in my first practice told me, on one of my stops along the journey, I was going to birth at Inova in Alexandria. That means you have to have a mom who is comfortable staying home until the last minute. If you have a good doula to support you, it is definitely possible.
I am not sure about Prince William but if it is a small hospital, there is a good chance they can't do VBACs. A few years ago ACOG pronounced that hospitals without a surgical team standing by 24/7 to perform a cesarean could not do VBACs. And of course all hospitals comply even though ACOG is merely a trade union, but none the less, they seem to set industry standards.
Another reason a hospital can have a low VBAC success rate is they might have been socked with a lawsuit in which case they will be pretty darn cautious about doing VBACs, even if they did everything in their power to prevent tragedy. Sad.
I just wanted to send some encouragement your way. I VBACed a 9 pound 1 ounce baby, so don't let that scare you!
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